Dear Dr Rassman
Consulting a transplant doctor in my area , he suggested that shock loss can be prevented by using rogaine a few weeks before and after the transplant . In previous replies of yours i see that you recomend the use of propecia for shock loss prevention . So i am a bit confused . Propecia , Rogaine or both ?
Propecia is absolutely better for preventing shock loss. Adding minoxidil will not hurt.
I received this email from a patient of mine and I have reposted it below with his permission (removing any identifying information, of course). This was not solicited, and it serves as an example of those men out there that are looking into hair systems (otherwise known as wigs or toupees). The price chart at the end of this post could be a wake-up call to many that think hair systems are cheaper than hair transplants.
In the end, transplanted hair is YOUR hair and the only maintenance you might need to do for it is to use shampoo and perhaps even use a comb. Oh, and visit a barber from time to time, if you’d like. You know, the things you did when you had hair the first time.
And now, the patient email…
Dr. Rassman:
As usual, it was good to meet with you to discuss my case. It is amazing that what we (operative word here) will accomplish in 21 months negates over 13 years of living with worry and dread about my hair loss! On some level I am certain you understand the value of your work; on the other hand, it is impossible for you to fully comprehend what you and your great staff at NHI have done for me and your other patients!
Here is a breakdown of my costs from a hair replacement salon in Los Angeles from June 2000 through January 2006. I wore a competing hair system from 1995 through 2000, but did not keep thorough records of those costs. Therefore, the $16,000+ indicated on the spreadsheet does NOT include the previous five years, so the total amount I spent on hair systems is actually higher that what my spreadsheet shows. In fact, I am certain I spent more on hair “replacement” than what I will spend on 5000+ transplants with NHI.
To be fair when you reprint this spreadsheet, post the the following as well:
- This spreadsheet is ONE PERSON’S experience with hair systems. It was my reality and should be viewed as such. Your costs will vary from my mine.
- The price for a hair system included two of them: wear one while the other gets service or cleaned.
- The months where there is no dollar amount were the times I did not go to the salon for servicing.
- I work in an industry that required my systems to look absolutely real at all times. The months where you see me spending $200-$400 were instances when the unit had to be colored or have hair added. Again, in my case it was a necessity. If you are in, say, another profession like a machinist, you may not have to obsess over your hair system. You WILL have maintenance, though, perhaps not as much. Also, to be fair, some people do most of their own maintenance, so their costs would be lower as well.
- In June 2000 the systems were just over $3000. Flash forward to 2004 and they were over $5000. I got 4 years use out of mine before they were replaced, and that was on the higher end of the average life cycle because of my meticulous maintenance. They might have had to be replaced before that if I did not treat them so well.
I wonder what systems cost today in 2007?
Bottom line: I spent $16,000+ over five years wearing hair. Sure, the initial costs for systems were cheaper than surgery, but their VALUE quickly fades over time. It costs more upfront for a high quality transplant, but its VALUE over the course of your lifetime is incalculable.
Thanks again for everything. Looking forward to my next transplant session.
Here’s the spreadsheet he sent me with the costs incurred for purchasing and maintaining his hairpieces.
Hair System Costs By Month |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2000 | 2001 | 2002 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2003 | 2004 | 2005 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2006 | Grand Total (after only 5.5 years) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
$16,257.40 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
How soon can we expect to see an FDA approval for Avodart for male pattern baldness? also, what would be the best treatment for the itchy, flaky scalp associated with MPB? i’ve been using Neutrogena’s T-Gel and T-Sal, both of which don’t seem to work to well.
I do not know the time frame of the FDA approval process, but I do know that FDA approval for Avodart (dutasteride) for the treatment of male pattern baldness (MPB) is pending, awaiting the proper scientific studies that determine safety and effectiviness. Keep in mind Avodart and Propecia both work in similar ways targeting DHT (Dihydrotestosterone). Also note that blocking 100% of DHT will not stop or reverse MPB completely, as there are other factors (not yet discovered) in MPB. Avodart may have more side effects that Propecia (probably so) depending upon the final recommended dosing.
Itchy or flaky scalp is not associated with MPB. If you have an itchy or flaky scalp you can try various shampoos or see a skin specialist (dermatologist). There is no particular shampoo that I recommend. Shampoos do not affect MPB.
If you are a male and have been diagnosed with female pattern hair loss would a DHT blocker like propecia or avodart still be effective? or is it caused by factors other than DHT?
Men with diffuse hair loss do not have the female version of the process. It is possible that you might have DUPA (diffuse unpatterned alopecia) and some doctors may call this “female pattern hair loss” because it is diffuse and does not follow the typical Norwood classification chart for male hair loss. Before going into the use of drugs, you should try to find out for sure what is wrong with you. If you have DUPA, then Avodart or Propecia may or may not be effective (it is not clearly known). In any case, you need to have this discussion with your doctor. Of course, you need to get a good diagnosis with mapping out your head for miniaturization.
dear Sir,
I’ve read the article about relationship between Thymus Gland and Hair Loss/Growth at thymuskinshampoo.com. Is it really true about this method? Actually I already use Minoxidil and My hair just growth, but I have to stop it because my blood pressure decrease 90/50 (normally 110/70). So, I have to find another way to growth my hair.
Thanks in advance
You must be cautious about all the information available on the Internet. Not everything you read is true, and even subtle truths that can be massaged to fit a certain agenda. It seems you need to see a knowledgeable doctor who can discuss all the options. To date, only minoxidil and finasteride (Propecia) are approved and proven to work for androgenic alopecia (AGA) or male pattern balding (MPB). Some people can not tolerate minoxidil, because it can drop your blood pressure.
My teenage daughter is loosing a lot of hair. She also has protein in the urine. Could that be related at all, and should we be concerned about the hair loss? It is more than the normal 100 strands a day.
Protein in the urine could be due to serious medical conditions. If your daughter is losing hair, it may due to the stress on her body from some medical condition (some diseases can cause hair loss). The hair loss may be related, but it is also normal to lose 100+ hairs a day (100 is not a finite number in relation to this — could be slightly more, could be less). She should be under the care of a physician.
How does one go about obtaining a prescription for propecia? Thanks
You need to make an appointment with a doctor. Any doctor can write the prescription. If you’d like to make an appointment to see me, you can call 800-NEW-HAIR or visit Request Additional Info page to have someone from my office contact you.
If you are losing hair and focused on hair loss issues, you should consider getting your hair mapped out for miniaturization so you will know for sure what is wrong and get some baseline measurements to determine the value of the drug over time.
I am 54 and was diagnosed with andro alopecia. Please tell me,will I lose all my hair or will it grow back after some time? My hair is the only nice feature in me and I am losing it .I am very depressed about that. Thank you for any information.
Androgenetic alopecia in women does not usually get better, but unlike men, women rarely lose much hair. The process is worse when a woman goes through menopause. Minoxidil may help and is worth a try.
hello;
I am taking Propecia along with Rogain. I just bought a new product called doctor lewenberg’s formula. it is 2% minoxidil with 0.025% tretinoin (retin-a). Will this product work better than monoxidil alone? also, I am using propecia and would like to stop because I believe it is effecting my sex life. Low ejaculate folume is my proplem. Do you think that stopping the propcia will help with that problem and do you think that the new minoxidil formular is better than minoxidil alone/ thank you.
I receive questions like this almost everyday. I often find it amazing and humorous since people purchased these shampoos/formulas for treating their hair loss and yet then they ask me if the various products actually work. Sometimes these products are so overpriced and people are still hoping against hope that these will be the magical cure they are looking for.
I looked into pricing for Dr. Lewenberg’s Formula, and their site says, “You will not achieve regrowth unless you use 10 bottles over 3 month period.” The “original formula” will set you back $300 for 10 bottles, while their “new and improved” stuff costs $350 for 10 bottles. Yes, it is priced higher than Propecia (an FDA approved and proven medication), yet apparently some people still buy this.
Retin-A produces irritation of the skin, a sort of light burn which is thought to increases the circulation as the body tries to repair the burn. As a result, it is theorized that blood supply to the scalp increases and any medications such as minoxidil (which is in Lewenberg’s formula) gets better absorbed. There is no firm conclusion on burn effect / increased circulation with Retin-A and I would rather use a higher concentration of the generic minoxidil (5%) and even Rogaine Foam 5%, which also has better absorption.
If you are having side effects from Propecia, you need to discuss it with your doctor that prescribed you the medication. In my opinion, Propecia is the best medical option for men with androgenic alopecia.
As I’ve often said, “It is a buyer beware market“. Just remember, there is no proof that any of these products really work (besides minoxidil and finasteride). For more about Dr. Lewenberg’s Formula, see Hair Loss Help – User Reviews.
I am attending cosmetology school and my theory teacher told the class that when u shed hair, if hair comes out and has the little white bulb on the end of the hair strand than it is an internal problem such as thyroid or tumors and if it doesnt then that means its more than likely an external problem and me and 2 of my friends have the bulb on the root of our hair strand, does that mean that we have something wrong?
It is normal to see a white bulb on a pulled hair. There is no connection to diseases or tumors and the white bulb at the end of fallen hairs. If you pull your hair (don’t make a routine of it) a few hairs will come out and some of them will have white bulbs. Hair coming out is part of the hair cycle and the hairs that come out are about to go into telogen.
Hair follicle cells have three phases of growth:
I was reading some of your blogs and in “Sudden Hair Loss Years After Transplant” from November 23 2005 it makes mention of nasenx possibly causing hair loss. I am taking a similiar medication called Fluticasone Propionate, could this cause hair loss? I use it as directed which is 1 spray per nasal per day. I actually started it the same time I started Propecia which has been 4 months ago. I am 28 years old and MBP runs in my family. Propecia has slowed down the hairloss and hopefully I will see some regrowth in the near future.
I doubt fluticasone is causing hair loss. Fluticasone is a medication used for seasonal allergy. If you have been reading this site, you should know that medications (such as fluticasone) are the last on the list of the cause of hair loss. If you are losing hair, it may be due to male pattern balding in which you are taking Propecia for. You should get your scalp hair mapped out for miniaturization and get a diagnosis from a reputable and competent physician.
Dr. Rassman,
DHT type II is found predominantly in hair follicles
DHT type I is found predominantly in the skinDo you know if the inhibition of DHT type I can negatively impact the rate of skin aging? Pseudohermaphrodites offer a good biological modelf for type II deficiency, and I haven’t heard that they age any differently than men with normal hormonal profiles. But what about type I deficiency? Are you in contact with any dermatologists who might know about this, or at least have a theoretical response?
There are drugs that block both type I and II DHT, but they do not impact skin and aging. Biochemistry and the most logical scientific reasoning and models do not always correlate with what we observe. Blocking 100% of DHT (type I or II) does not stop or reverse hair loss and a 100% block of DHT is unlikely from a practical point of view.
hellosince 1988 I have lost all the hair on my body and head ( alopecia totalis ) I was almost 12 years old back then when it started. my father had alopecia areata for a short time when he was 32 years old. my brother also had alopecia areta when he was 19 also for a short time
I HAVE 3 QUESTIONS
- I am planing to have kids , what are the chances that they will also have alopecia and when (before birth or after birth ) and how severe WILL IT BE
- my second and most important question is , is there any medication that I or my wife can take to stop or minimize any chances for my kinds having alopecia.
- my third and last question , is there any hope for me after all these years of having my hair back ( any new medication out there. I must also say that for the last 2 monthes now, alot
of black and white hair started growing on my head .what should I do.please help
Alopecia areata (and alopecia totalis) run in families and its genetic transmission can be anywhere from 10 to 20% in general. Currently there are no medications to predict, prevent, or cure these conditions. For more info, please see National Alopecia Areata Foundation.
What can we do about the facial edema we get from minoxidil? Is there any way to minimize or reduce the swelling, especially upon waking up?
Stop using minoxidil if you have developed facial edema from it. It may be a serious sign of an allergic reaction. You need to discuss this with your doctor, as there may be other medical problems you are not aware of.
I had a partial Hysterectomy in January 2007. My ovaries are still intact. For about 3 months now I have had tons of hair just break off at the scalp, I went to my gynecologist that performed my surgery he ran some labs and told me that my hormone levels are fine, but I am having severe hot flashes and daily hair loss(it’s coming out in clumps) It has me in tears and I used to have beautiful thick hair. Can you give me some helpful information, Please. Thank you
You need to be examined by a good doctor who understands hair loss in women. Hair loss is present in almost 50% of post menopausal women.